MU Health creates peer support program for caregivers

Saturday

Health care professionals are there to treat and care for patients, but what happens when the patient they are caring for has a negative outcome?

University of Missouri Health Care System is making sure those health workers are being taken care of with a peer support program called forYOU, which is being used in hospitals across the country.

In 2006, Susan Scott became a patient safety coordinator at MU Health Care. Scott's job was to work with clinicians after an "unanticipated event" and see what can be learned. A negative outcome in this situation equates to an unexpected death of a patient.

However, at the end of her sessions, Scott could see how much the events had affected the clinicians. Scott said she often would ask how they were doing and at times she would find grown men reduced to tears. Scott began using the term "second victim" to describe the health care workers who suffered physically or emotionally after a patient has a negative outcome. Patients and their families are referred to as first victims.

"I reached for a tool kit, but I didn't have any tools," Scott said. So, she teamed up with Laura Hirschinger, clinical improvement specialist at MU Health Care, to see what tools they could create to help staff after an incident.

After approval from the institutional review board, an ethics committee that approves biomedical or behavioral research of humans, Scott and Hirschinger began interviewing "second victims" to see what kind of support and recovery they needed.

Hirschinger said 31 health care providers were interviewed about how negative patient outcomes affected them and who they turned to for support. Scott said of the 31 interviewees, more than 20 had never shared "what it was like for them to go through the experience." These findings were published in BMJ Quality & Safety Health Care.

The interview responses led to a survey asking almost 900 people what their ideal "response" team would look like. The findings helped to create the peer support group, forYOU, which operates on a three-tiered model. The model was published in The Joint Commission Journal on Quality and Patient Safety.

Tier I relies on local, inner unit support. Scott said this would include co-workers or supervisors asking if the second victim is OK. "At this level, this will take care of 60 percent of second victims," Scott said.

For Tier II, managers identify colleagues who are natural supporters, and they are invited to a training course that entails 18 hours of didactics, small group work and simulation. Those individuals are then ready to provide crisis intervention and peer support mentoring. About 25 percent of second victims would be supported through this tier.

The third tier includes 15 percent of second victims, who require quick access to professional counseling such as talking with social worker, chaplain or clinical psychologist.

Scott said it took nearly three years for the program get up and running, and she is excited to see it spreading to hospitals across the country, including St. Francis Medical Center in Cape Girardeau and Saint Patrick Hospital in Montana.

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